"I refuse to develop type 2 diabetes."

Ben ReedAge: 57Occupation: Deputy chief of policeHealth goals: Ward off the
development of type 2 diabetes

Ben Reed knows all too well the damage type 2 diabetes can do. The disease ravaged both his father and grandfather, stealing their eyesight, vitality, and, in the case of Reed’s grandfather, his life. When Reed turned 55, the longtime deputy chief of police realized he was headed down the same path. “I had high blood pressure; I was on cholesterol medication,” Reed says.

“I was 50 pounds overweight, and I was ridiculously stressed out and out of shape. My blood glucose level was very high and, given my family history, my doctor said it was possible I would go blind by age 60.”

With so many warning signs staring him in the face, Reed sprung into action. He began walking daily and changed his diet, cutting out all sugar, white flour, and starches, including some vegetables such as peas, corn, and potatoes. Now 57, Reed is 50 pounds lighter and off the cholesterol-lowering drugs. His blood pressure and blood sugar are also at healthy levels. But given the seriousness of type 2 diabetes, Reed wants to make sure he is doing everything he can—including consuming the right vitamins, minerals, and other nutrients—to prevent this deadly disease.

Ben Reed: Given my health history, if I hadn’t made changes to my diet and began exercising regularly, what is the likelihood that I would have developed type 2 diabetes?

Ann Kulze, MD: The single most important risk factor for type 2 diabetes is being overweight or obese. To give you some perspective, if you are overweight, your risk of diabetes increases sevenfold. It is virtually guaranteed that you would have developed full-fledged diabetes. You are a male over 45 with a first-degree relative who had the condition. You were 50 pounds overweight, you were not physically active, and your blood sugar was abnormally high.

Ben Reed: Why is type 2 diabetes so harmful?

Ann Kulze, MD: With type 2 diabetes, the hormone insulin no longer works properly. This is different from type 1 diabetes, a condition caused by the body being unable to make insulin. People with type 1 diabetes, also known as juvenile-onset diabetes, have to take injections of insulin daily for the rest of their lives. With type 2 diabetes, the pancreas can still produce insulin, but its action in the body is impaired. Insulin is very important; this hormone transports the glucose from your bloodstream to the cells, where it can be used or stored for energy. If you don’t have insulin that is working properly, these fuels don’t get delivered to the cells and therefore build up in the bloodstream. At elevated levels, blood glucose and blood fats can damage important structures and tissues in the body, including nerves and blood vessels.

Type 2 diabetes is the sixth-leading cause of death in the United States, and it takes an average of 13 years off your life span. This disease increases the risk of death from heart disease and stroke twofold to fourfold, and it is the leading cause of kidney failure, blindness, and limb amputation. Type 2 diabetes also increases the risk of dementia and Alzheimer’s disease. Furthermore, a recent study found that type 2 diabetes increases the risk of death from certain cancers, such as liver, breast, pancreatic, and colon cancer (American Journal of Epidemiology, 2004, vol. 159, no. 12).

Ben Reed: What are the symptoms associated with type 2 diabetes, and what tests should I have done to check for this disease?

Ann Kulze, MD: The classic symptoms of type 2 diabetes, once it is fully manifest, are frequent urination, frequent thirst, and unexplained weight loss. But it is important to note that in its early stages, type 2 diabetes often doesn’t have any symptoms at all. That is why it is so important to know the risk factors and to have your doctor do a fasting blood glucose test if you are at risk of developing this disease.

Ben Reed: During the last year, I’ve cut sugar from my diet and focused on eating better and losing weight. What else could I be doing to ward off type 2 diabetes?

Ann Kulze, MD: The most important step is losing that excess body weight, so congratulations on losing the extra 50 pounds you were carrying around. Exercise is the second most powerful strategy. Aim for 30 or more minutes of moderate aerobic activity five or more days a week. Walking, as you’ve been doing, is a fantastic form of exercise. Strive to walk at least 10,000 steps a day; using a pedometer is an easy way to make sure you’re walking enough each day. Cycling, swimming, stair walking, raking leaves, water aerobics, and basketball are great forms of exercise, too.

In regards to your diet, cutting out sugar is excellent. But also avoid those foods that we know are associated with the development of diabetes. These include highly refined, high-glycemic-index carbohydrates, such as white flour products, white rice, and white potatoes. Also avoid saturated fats found in red meat, poultry skin, and whole dairy products; and trans fats, which are those sinister man-made fats found in margarine, shortening, fast food, and processed food containing hydrogenated or partially hydrogenated oils. All of these foods promote insulin resistance, which is the underlying metabolic abnormality that ultimately leads to type 2 diabetes.

On the other hand, some foods can actually reduce your risk of type 2 diabetes through their potential to aid in the maintenance of a healthy body weight or to improve the function of insulin. Low-glycemic, fiber-rich fruits and vegetables are fantastic choices for you. My top picks for diabetes protection include onions, broccoli, okra, brussels sprouts, dark leafy greens, tomatoes, red and yellow peppers, berries, cherries, apples, citrus fruit, pears, plums, apricots, and peaches. Many of these fruits and vegetables are high in carotenoids, a class of phytochemicals that seems to be protective against type 2 diabetes (Diabetes Care, 2004, vol. 27, no. 2). These antioxidant phytochemicals are plant substances that bolster the body’s defenses against a wide range of diseases, including cancer, cardiovascular disease, and diabetes. Beans, legumes, and whole oats are also excellent choices because they are especially high in soluble fiber. Soluble fiber can lower and help stabilize glucose and insulin levels in the bloodstream, and this can be protective against insulin resistance.

Ben Reed: What vitamins and other supplements should I take?

Ann Kulze, MD: Some studies show that certain nutrients seem to be protective. I mentioned the carotenoids. Others include vitamin E, chromium, and vitamin D. If you’re worried about the development of type 2 diabetes, focus on foods rich in these important nutrients.